What is this “Mommy Makeover” people are talking about?

Mommy Makeover is the combination of procedures used to restore form in the areas of a woman’s body that have been harmed by pregnancy. Abdominoplasty, or tummy tuck, and breast augmentation are commonly included in this combination, sometimes with the addition of breast lift, or mastopexy.

Many women find that their abdominal shape has lost definition, even after they have lost their excess pregnancy weight. Most rightly conclude that the extra skin which developed on their abdomens to accommodate the growing baby inside has failed to tighten back to its pre-pregnancy tone. Many conclude, often wrongly, that there is still a large area of localized fat in the abdomen that is causing the protrusion. In the most severe cases, moms who are weeks to months postpartum are asked by hapless people, “When is the baby due?” At that point, the answer is difficult for both parties.

 

Usually, the abdominal protrusion results from an injury to the rectus, or “six-pack” muscles such that they are no longer connected to each other in the midline. This allows the intestines and other abdominal contents to protrude outward, like a giant hernia. To the extent this has happened, the waist also loses its inward curve, and becomes more straight-up-and-down. The pubic area often drops as well. The hidden aspect of a good abdominoplasty has to do with the muscle repair and tightening that goes on beneath the skin. In many cases, it is now possible to perform a drainless tummy tuck. For more information about that term, please see our site at http://myplasticsurgerygroup.com/body-procedures-carmel/tummy-tuck/.

The breasts often undergo significant change after pregnancy and/or breastfeeding. At the very least, a diminishing amount of firm breast gland tissue is replaced by a softer, fatty tissue. This can result in a deflated look to the breasts, or a smaller breast size with the same amount of skin wrinkled over the tissues underneath. A breast augmentation can restore the volume and re-inflate the wrinkled skin envelope. This can be done via traditional or endoscopic approaches using saline or gel implants. The various shapes available make it easier to match a woman’s chest width with her preferences for size and upper breast fullness. For more information, see our hiddenscar.com website.

If the breast has underlying sagging, or ptosis, the nipple will have dropped below the level of the infra mammary fold, that fold of skin that divides the breast from the upper abdomen. If a breast augmentation is done on this type of breast, without doing anything else, the newly augmented breast mound will be higher on the chest than the nipple. This can look worse than the original sagged breast unless a lift or mastopexy is done.

A mastopexy is done by deciding where the nipple, surrounding areola and breast tissue should be elevated. By means of incising around the areola and straight down from there to the bottom of the breast, the tissues are separated from the skin, and mounded up higher on the chest. The excess skin is then taken out beneath the breast where the scars can be better hidden.

No patient, and no plastic surgeon want to do a breast lift unless it has to be done. The lift takes extra time, and puts extra scars on the very part the person wants to see improved. The lift, if it is believed necessary, is planned for the final stage of the combined operation to make absolutely certain that it must be done. Occasionally the augmentation fills out the skin enough in the lower part of the breast so that the nipple no longer appears to fall below the breast, but is now more centered. Other times the abdominoplasty tightens the upper abdomen skin so that the infra mammary fold is pulled down enough to center the nipples. In these cases, the lift is not done.

This combination of procedures is done in a certain order to maximize results and minimize incisions. Many patients prefer this combination over a plan which would involve two, or more separate operations. Recuperation time and money are saved for these patients who are good surgical candidates and want to combine abdominal and breast rejuvenation into the Mommy Makeover.